Uterine prolapse is a condition where the uterus is displaced from its normal position into the vaginal canal due to weakened pelvic floor muscles and ligaments. This condition can range from mild, where the uterus drops slightly, to severe, where the uterus protrudes out of the vaginal opening. It is most commonly observed in women who have experienced childbirth, menopause, or chronic conditions that increase pressure on the pelvic floor. 

In Australia, uterine prolapse is now recognized as one of the most common health problems among women. Whilst a small degree of asymptomatic uterine prolapse may be considered normal, it can still lead to various issues for many women. Read on to learn more about uterine prolapse and what physiotherapy can do to help.

Causes and Risk Factors

Common causes and risk factors for uterine prolapse include:

• Childbirth: vaginal delivery, especially multiple or complicated deliveries (e.g., forceps can weaken the pelvic floor).
• Aging and Menopause: reduced estrogen levels during menopause can lead to decreased muscle tone and support of the pelvic floor.
• Chronic Pressure: conditions such as chronic coughing, constipation, or heavy lifting can strain the pelvic floor.
• Obesity: excessive weight places added pressure on pelvic structures.
• Genetic Predisposition: some women may have inherently weaker connective tissue.
• High-impact sports: women who have been athletes / high-level athletes, particularly those who play in high-impact sports (e.g., gymnastics, running).

Symptoms of Uterine Prolapse

Women with uterine prolapse may experience a variety of symptoms, such as:

• A feeling of heaviness, pressure or pulling in the pelvis
• Visible or palpable bulge in the vagina
• Lower back pain
• Urinary problems, such as leakage, incontinence, or difficulty emptying the bladder
• Frequent urinary tract infections
• Bowel issues, including constipation or bowel urgency (needing to go to the toilet very suddenly)
• Discomfort or pain during sexual intercourse

The Role of Physiotherapy in Managing Uterine Prolapse

Physiotherapy is a non-invasive and effective approach to managing uterine prolapse, particularly in its early stages. It can help with:

• Reducing symptoms and discomfort
• Improving pelvic floor strength and function
• Delaying or preventing the need for surgical intervention
• Enhancing quality of life

A trained women’s health physiotherapist can tailor a program to strengthen the pelvic floor and alleviate symptoms through the following treatment techniques.

1. Pelvic Floor Muscle Training (PFMT)

Pelvic floor exercises, sometimes known as Kegels, are specific exercises that involve contracting and/or relaxing the pelvic floor muscles to:

1. Activate the pelvic floor muscles with the correct technique.
2. Increase the strength and endurance of the pelvic floor muscles.
3. Increase the functional use of pelvic floor muscles (i.e. ensure the muscles function properly during the day).

A physiotherapist can ensure proper technique and progressively challenge the muscles for maximum benefit.

2. Biofeedback

Biofeedback devices help women identify and activate their pelvic floor muscles correctly. These tools provide real-time feedback, making exercises more effective and reducing the risk of performing them incorrectly.

3. Postural and Breathing Techniques

Improving posture and breathing mechanics can reduce unnecessary pressure on the pelvic floor. Diaphragmatic breathing, for example, helps coordinate core and pelvic floor muscle engagement.

4. Lifestyle Modifications

A physiotherapist can provide guidance on lifestyle changes, such as:

• Avoiding heavy lifting
• Managing chronic coughing or constipation
• Incorporating regular, low-impact physical activity to maintain overall pelvic health

When to Seek Help

Uterine prolapse is a challenging but manageable condition. Physiotherapy offers a safe, effective, and empowering way to address symptoms and improve pelvic health. If you experience symptoms of uterine prolapse, suspect you have uterine prolapse or are seeking some preventive care, book in with our expert Women’s Health physiotherapist at UniquePhysio now. Early intervention with physiotherapy can significantly improve outcomes and help prevent progression.